【2331】Appropriate inspection methods

Style: Romance Author: Fat mother is kindWords: 1083Update Time: 24/01/12 05:52:06
Before taking medical measures, a clear diagnosis must be made quickly in non-rescue situations.

If you choose to undergo auxiliary examination if you suspect intussusception, previous textbooks usually talked about using a barium meal.

This is because at that time, there was a shortage of B-ultrasound machines and CT machines, and only X-ray machines had abundant resources.

Advances in medical technology allow doctors to have more choices and eliminate inappropriate examination methods.

For example, a barium meal is actually very inappropriate because intussusception causes intestinal obstruction. If you take a barium meal again, it will only aggravate the intestinal obstruction.

CT has radiation, so B-ultrasound is quick and convenient.

There is a B-ultrasound room in the emergency department of Seoer. It’s fastest to take the child over and do it.

Several people came to the B-ultrasound room with their children in their arms. Since this child's condition was quite urgent, I explained it to the other children and parents in line and jumped in line directly to the front for examination.

There are four typical symptoms of intussusception. One is paroxysmal abdominal pain manifested by the child crying and then becoming quiet. The second was vomiting, which this child had. The third one is jam-like stool, that is, bloody mucosal stool, which this child does not have. The fourth is a sausage-like mass, yes.

There are only two symptoms out of the four, which can only be called preliminary suspicion, and instrument-assisted examination is necessary. Vomiting and sausage-like masses are signs of intestinal obstruction and are not necessarily caused by intussusception. For example, another common clinical disease in children is ascariasis. Roundworm clumps can also cause intestinal obstruction, but the age of onset is generally older children, but it is true that this disease usually does not cause bloody stools. If the doctor touches the lump with his hand, the surface of the roundworm mass will be like a cord. Having said that, depending on the feeling of the doctor's hand, each doctor's touch is different, it's really like Schrödinger's cat and I can't explain it.

B-ultrasound examination is much more intuitive. According to the principle of intussusception, B-ultrasound can detect the phenomenon of a large ring within a small ring, which is called the concentric circle sign.

Clinicians stood around behind the B-ultrasound doctor and watched. Two low-echo clusters appear on the instrument screen, with a high-echo band in the middle.

"It should be intussusception." Shoe'er's B-ultrasound doctor is very knowledgeable about this disease and is very familiar with it. He can tell it with just a few glances.

Another sweep of the kid's appendix, just in case. Acute appendicitis is also a very common and easily ignored acute abdomen in infants and young children. The appendix is ​​connected to the cecum, so it is close to the location where the disease occurs, so it needs to be differentiated and identified.

There is no problem after scanning the child's appendix. If you want to be more cautious, you can go for CT. CT is more time-consuming, and there is no need to do additional CT if there are clearer test results.

A great doctor can save patients and their families money.

The focus now is on the next medical strategy.

In the case of intussusception, if severe intestinal necrosis occurs, an operation must be performed immediately to cut off the dead intestine and perform an enteroenterostomy. Inform the emergency nurse to call and ask the inpatient general pediatric surgeon to come down and see the child so he can make a decision.

It just so happens that today is the first day of work for all employees back to the hospital, and it is the busiest time for everyone. Many surgeries that had been delayed by the holidays were scheduled to be performed in a hurry, and the surgeries on the first day were fully booked. It is said that all the pediatric general surgeons have gone to the operating room, and it will take some time to notify the doctors to come down from the operating room.

The doctor in charge continues to be the emergency doctor until someone from the inpatient department comes down to pick up the patient.

Seeing that the child's condition was getting worse, Xie Wanying suggested: "We should seize this time and try to reset the child, Doctor Duan."

------Digression-----

Thank you for your support! ! ! Good night, dears~

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